August 21, 2025 • 35 mins
APTA Nebraska delegates share insights from the House of Delegates, revealing how key votes on professional policies and bylaws shape the future of physical therapy practice across the state and nation. The podcast explores the inner workings of APTA governance and highlights critical changes that impact all physical therapists and assistants.
If you're interested in getting involved with APTA governance, reach out to our current delegates. APTA House of Delegates
Links:
Primary Care:
APTA Federal PC SIG Canva Presentation
Competency Based Education:
New APTA Report Details Performance Outcomes for PT Entrance Into Practice
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:01):
Welcome to the APTA Nebraska podcast, where we dive
into the stories, challenges andinnovations shaping physical
therapy in our state.
We're here to advance, promoteand protect the practice of
physical therapy, optimizing thehealth and quality of life for
all Nebraskans.
Join us as we connect withexperts, share insights and
(00:22):
build communities throughout ourprofession.
Connect with experts, shareinsights and build communities
throughout our profession.
Welcome back to the APTANebraska podcast.
I'm Brad Dexter, your host, andI'm joined by Bobby Greasy and
Ian Thompson today, who aregoing to share a little bit
about their time at the House ofDelegates in July.
Guys, welcome to the podcast.
Speaker 2 (00:39):
Thank you very much.
Thanks for having us.
Speaker 1 (00:41):
So just a little bit of background.
If you're not as familiar withhow the House of Delegates works
and guys, feel free to jump inand correct me on anything that
I miss.
Here there's a House ofDelegates that is responsible
within the APTA for continuingto kind of move our profession
forward.
(01:01):
Is that a fair way ofexplaining that?
Yep, continuing to kind of moveour profession forward Is that
a fair way of explaining that?
You guys, on behalf of ourstate, you were there as a
delegation.
You're voting on motions thatare on the floor.
Part of that process is justrecognizing that physical
therapy as a professioncontinues to evolve and change
and we need to make sure thatyou know what we.
(01:22):
You might have to help me withthe language behind this, but
what we're writing about ourprofession is kind of catching
up to that as well.
Is that fair to say?
Speaker 2 (01:31):
In a nutshell In a nutshell.
Speaker 1 (01:33):
I'm sure you could describe that much better than
me, but you were telling mebefore, bobby, that, okay, there
are 438 voting delegates at theHouse of Delegates.
That does not representeveryone that's there,
necessarily.
I think there's a naturalquestion then of well, how do
you know how many delegates youget for each state?
That's representative of theamount of members that you have
(01:56):
in your state chapter, right?
Speaker 2 (01:57):
So state membership and we have five voting
delegates and we're super close,so if we got anybody on here
that wants to become a member,then we could ultimately get up
to six voting delegates okay, soour voice, then, as a state
within the APTA, as a nationalorganization is, is just a
little bit louder than with, youknow, another vote right, like,
(02:20):
like, north Dakota only has twovoting delegates OK, because
their membership of course isnot very large.
Up there, alaska too, I mean,there's these small states and
they all have two.
So we are actually pretty luckyin Nebraska to have five,
because we're still a smallstate, but we have five voting
delegates because our membershipis so strong.
Speaker 1 (02:42):
It's so high.
That's great, yeah, okay, so,as membership chair, there's
everything you need to know.
We need more members and it'svaluable because it gives us a
voice at that national level too.
Thanks for saying that.
I appreciate that.
So you guys I was lookingthrough, kind of, the agenda for
(03:04):
House of Delegates.
There were 48 different motionsthat you guys had to look
through.
Can you maybe just share withthe audience?
When do you get those motions?
How many pages are there?
What's your responsibility toread through those motions
before you actually end up onthe floor and voting on these
things?
Speaker 2 (03:23):
Yeah, so we are changing with the times and
developing our motionsdifferently now than we have in
the past, and so our first phasefrom February through April,
was motion concepts, and so wehave this hub online through the
APTA and all of us chiefdelegates and delegates have the
(03:45):
motion concepts in front of usand there's discussions through
emails that go around for thefirst three months of developing
a motion, and we didn't bring amotion to the House that wasn't
in concept form to start with.
So I don't know if that'sconfusing.
So we're going from concept tomotion.
(04:05):
If the concept is not accepted,then it doesn't become a motion
and then, once it becomes amotion, then we start to work on
dialogue about that motion andthen we don't debate, and that's
confusing, I know, but we don'tdebate a motion until the House
comes about in July.
Speaker 1 (04:25):
Okay, so I mean in other words like, yeah, you
can't, you don't want to have100 motions that everyone's
responsible for, and so there'sa process that you go through to
even get that concept or ideato become a motion, something
that's valuable enough thatHouse of Delegates needs to
actually vote on that enoughthat House of Delegates needs to
(04:48):
actually vote on that.
Speaker 2 (04:48):
In the past couple years we've had a couple of
motions that haven't been seenas something that's beneficial
to the association, and so theboard and the directors and
everybody is trying to develop aprocess that's more transparent
so that everybody has a say all438 voting delegates have a say
before it becomes a motion, tomake sure that it's something of
(05:09):
value to the association.
Speaker 1 (05:11):
Okay, so that kind of happens between February and
April and then it moves intomotion.
You guys get those motions,review them, and then you have a
chance to vote on them at Houseof Delegates, right?
Speaker 2 (05:24):
So, just to give you an example, we had over 3,000
emails in our motion conceptdevelopment.
That's very busy.
That's a lot of people givinginput and getting input, because
it's not just somebody tellingyou what they think, it's also
there's questions and thenanswers from the APTA staff and
(05:47):
answers from the board ofdirectors to kind of help guide
our thought processes.
Speaker 1 (05:52):
Okay.
Speaker 2 (05:53):
It's busy.
I looked at my emails every day.
Speaker 1 (05:56):
Wow, that's maybe a good place for me to pause and
remind people that you guys alsohave full-time day jobs, right?
Speaker 2 (06:03):
Yep, bobby, you're in Shadron, yeah, I can tell you a
little bit about that.
I'm out in Shadron, nebraska,of course, a small rural
community hospital.
I've been practicing 23 years.
I've been a delegate since 2004, and I've been a chief delegate
since 2017.
I have a lot of experience inthe governance process and I
(06:24):
just have a lot of experience onhow we of experience in the
governance process and I justhave a lot of experience on how
we've evolved in the governanceprocess, because before there
was no computers, you didn'tbring your laptop.
There's no cell phones.
We just had three ring bindersof hundreds of papers.
Speaker 1 (06:38):
Wow, yeah, that means a heavy backpack.
Speaker 2 (06:41):
It was, everybody had a heavy backpack.
That means a heavy backpack.
Speaker 1 (06:43):
It was.
Everybody had a heavy backpack.
And, Ian, can you tell ouraudience where you're located
and what you do too?
Speaker 3 (06:50):
Absolutely.
I am an instructor in the DCEat Southeast Community College
in the PTA program.
I've been the well.
Originally I was a caucus repand I can talk a little bit
later about how that's evolved.
Rep and I can talk a little bitlater about how that's evolved.
But I was the caucus rep I waselected in.
I believe 2020 was my firsthouse.
(07:12):
I want to say I was elected in19,.
Actually, 2020 was the firsthouse which was a COVID house
and I've been going to themsince.
We've since changed to theengagement group and so it's our
role in governance is just alittle bit different than it was
prior, because now we have twovoting delegates that are part
(07:33):
of the PTA council and so wehelp to steer their decisions
when they go to the house floorand vote.
Speaker 1 (07:39):
Okay, thanks, yeah, thanks.
Thanks for giving us just alittle bit better idea of the
fact that, oh yeah, you guys areworking all long and then
you're maybe having to siftthrough 3000 emails over the
course of a motions.
That was on the floor and I'llbet our podcast listens would be
(08:07):
at maybe like one.
It would be my mom who wouldprobably last through that
entire thing.
But I do want to hear from youguys you know what kind of stood
out during your time at Houseof Delegates what do you think
would be of value for ourmembership in our state chapter
in Nebraska to be aware of?
Speaker 2 (08:30):
Yeah, thank you for that question.
So just a little background.
The governance process for theAmerican Physical Therapy
Association is our House ofDelegates and we are elected by
the state.
But then there's also sectionsthat will elect two members and,
like Ian said, the physicaltherapy council now physical
therapy assistant council hastwo members that are voting, so
(08:53):
438 votes on the floor.
We try to encompass everyaspect of physical therapy, so
it's education, it's clinicalbased, and then this year was a
bylaw year.
So then it's also something asimportant as code of ethics,
(09:15):
mission vision.
All those sort of things arebrought forth and voted on by
the House of Delegates.
Again, this year was bylaw year.
On the zero years and fiveyears we bring forth bylaws.
Code of Ethics was our mostimportant bylaw this year.
It's been a four-year processby a task force Gail, I was
(09:37):
saying earlier, gail Jensen saton this task force from
Creighton University.
She's just a wealth ofknowledge in the ethics area and
what was brought forward is webrought together PTA code of
ethics and PT code of ethics andmade one solid document.
Some of the verbiage wasdebated a little bit on the
(09:59):
floor and felt that it wasn'tpowerful enough, but when it all
came down to it.
We adopted the code of ethicswith almost a unanimous vote and
got a very good document goingforward.
For any litigation, for anyproblems that you see in your
(10:20):
day-to-day actions withcoworkers, please use that code
of ethics as a resource formoving forward, cause I think
it'll stand up for at least thenext 10 years as far as how
we're going to practice physicaltherapy.
Speaker 1 (10:38):
Can you guys maybe either one of you would you be
able to talk about like why?
Why is it important that the PTcode of ethics and the PTA code
of ethics kind of mergedtogether?
Speaker 2 (10:49):
Yeah, I mean Ian can can jump on this too.
But as far as having twodifferent documents, they didn't
.
They didn't coincide withtoday's practice standards, and
so what they did, instead ofhaving you go to two different
documents, is they just moldedit into one universal document
(11:10):
for both PTs and PTAs.
Just to you know, help thepublic, help lawyers understand
how physical therapists shouldpractice so that when they're
looking at these differentethical dilemmas, then you don't
have so many documents.
Speaker 3 (11:26):
And I think the one thing too is when we're looking
under physical therapistpractice in general, that's
where the physical therapistassistant falls is under
physical therapist practice, andso having as looking at us as a
team versus separate, thenwe're we're all, all should be,
we all should be ethical right,we all should be doing what's
(11:48):
best for our patients, what'sbest for the profession, those
types of things.
And so having one document thatserves physical therapist
practice the best, with thephysical therapist assistant
falling under that just was itjust made sense?
Speaker 1 (12:01):
Excellent.
Thank you, and Bobby, I think Icut you off a little bit.
Did you have anything else thatyou wanted to add on the bylaws
?
Speaker 2 (12:07):
Well, as far as the bylaws go, I think it's
important for members in thestate of Nebraska to know that
litigation can come aboutbecause of documents from the
APTA, and so it's reallyimportant that we keep up to
speed with what's happening inthe country, because we have had
(12:29):
trouble with physicaltherapists across the country.
There's no specifics and wecan't name anybody, but we've
had litigation against physicaltherapists because of different
core documents through thePhysical Therapy Association.
So the board and the APTA staffwas really big this year in how
(12:50):
we worded our documentationthat we passed in order to
protect every physical therapist, not just the members.
Now, the members, of course,are, so to speak, the most
important, but it also protectsjust everyday practicing
therapists too, because theassociation only represents 30%
(13:11):
of practicing physicaltherapists across the nation.
So it's important to also givethose non-members some
assistance as well, and so theAPTA Code of Ethics is one of
those documents that can moveacross the association and to
the non-members.
But as far as passing thedocuments, we're most concerned
(13:34):
with our membership.
Okay, so I did.
You know, as far as bylaws go,it's different every five years
on what our practice standardsare and how they're changing.
So, for instance the code ofethics was adopted.
So that means that it was thisfresh document that had never
been seen before by the housebecause there was two code of
(13:56):
ethics for PTs and PTAs.
So then we molded together.
So the adoption of that RC wasdifferent than the other seven,
because then the other sevenwere just amendments to already
standing bylaws and they didn'tall pass either.
So that's kind of interestingthat the House of Delegates
didn't feel like the changesthat needed to be made.
(14:18):
From the mainly the boardbrings forward the bylaw
amendments, mainly the boardbrings forward the bylaw
amendments.
They didn't feel like thoseamendments were of enough
substance and so some of thebylaws failed, which is kind of
ironic because then we'll haveto wait another five years.
We can see bylaws every year butyou have to vote them in to a
(14:39):
non-bylaw year by a two-thirdsvote and sometimes that can be
pretty tough to get in.
But I want to highlight onemore bylaw.
As far as an amendment goes andI want Ian to talk a little bit
about this we voted in anamendment that gives the
physical therapy assistant achance to run for a director
(15:00):
position, and a director is oneof nine people on the board, the
executive board that governsthe House of Delegates.
So you have APTA staff, youhave the board of directors and
then you have the House ofDelegates, is the governance for
(15:20):
the American Physical TherapyAssociation, and so that might
be a little confusing to people.
And again, I'm always up foranswering any questions if I get
emails or phone calls orwhatever questions you have
about the governance of theAmerican Physical Therapy
Association, because I don'tever get too many people that
are interested in it.
(15:41):
So I would entertain any andall questions if it's confusing,
because I'm sure it is to somepeople.
Speaker 1 (15:48):
Now, Ian, why don't you maybe fill us in a little
bit more?
Speaker 3 (15:51):
All right, I will talk about RC525, which was a
bylaw change that would grantthe PTA an opportunity to serve
on the board of directors, andoriginally we had hoped that we
would have a physical therapistassistant that would have a
designated spot on the board ofdirectors.
This was an RC that was broughtforth by the state of Oregon
(16:11):
and the PTA council.
Just a little bit of backgroundIn 2015, there were three
bylaws that were brought forthand, just like Bobby said, bylaw
years are the fives and thezeros, and so there were three
bylaws in 2015 that were broughtforward.
One was to give the full voteto the PTA at the component
level.
The other one was to allow aPTA to serve as a chapter
(16:35):
delegate and the third one wasthe opportunity to serve on the
board.
Well, that's taken a little bitof time, but in 2015, we got
the first one with the vote atthe component level, and
Nebraska was one of those firsteight states that voted that
through right away, so we werepretty happy about that.
Two years ago, we now voted inan RC that bylaw change that
(16:58):
would allow the PTA to serve asa chapter delegate.
So we were at two out of threeof those original bylaws from
2015.
And so the board of directorsone was pretty important to us
the AOTA, or our friends, ouroccupational therapy friends.
They do have a bylaw thatdesignates one particular
position or one position ontheir board of directors to a
(17:19):
CODA, but it doesn't limit thenumber that that can run.
And so currently there's twoCODAs on the board of directors
for the AOTA, and so that'ssomething that we were really
hoping for, and there was somedebate.
There was an amendment that wasintroduced pretty much right
away that asked that, instead ofa designated position, that a
(17:41):
PTA could run as an at-largeperson for those positions.
And you know, initially I thinkwe were really hoping for that
one position, because it may bedifficult for a PTA to to win
one of those positions against aPT, but there are some really,
(18:02):
really good candidates out thereright now.
So that was something then thatwe really thought a win is a
win, so whatever could get usacross the finish line, at least
allow us to potentially havethat voice.
We have a lot of PTAs out therethat are in leadership already.
There's's some, as myself, thatserve on the exec board at the
state level.
There's PTAs that are clinicowners and so allowing them to
(18:24):
have some of the same voicesthat our PT friends have as well
.
We thought was pretty important.
So we were pretty happy aboutthe bylaw and we were okay with
that amendment because now,instead of the one designated
position I mean technically,there was some talk about
whether a PTA could, essentiallyyou could have eight on the
(18:44):
board, which will never happenbecause there's a nominating
committee that's going to be incharge of helping to build that
slate to begin with, but it didallow the opportunity for us to
maybe have more people.
So, like I said, the AOTA hasone designated position but
right now has two COTAs that siton their board, and so we do
(19:04):
have the opportunity to run as aboard of directors for board of
directors position, and so,whether it's one or whether it's
two I know it will never beeight, but just the fact that we
can have one I think was areally big win for the PTAs and
there were I want to say at theend there were 17 co-sponsors to
(19:27):
that and it passed prettyeasily.
So we were happy about that andjust the wins that we've seen
for the PTAs.
I think there was adisassociation for a while with
the association itself with thePTAs, because we used to have a
vote and they took the vote wastaken away.
But now we've gotten back tothat full vote.
Now we have two voting members,now we can run as a delegate
(19:52):
position and so all of thosethings and even the delegate
spots.
That was a bylaw change thathappened in a non-bylaw year.
So, as Bobby said, we neededtwo-thirds vote just to hear it
and then we needed thetwo-thirds to pass it and we
were able to achieve that.
So just some wins for the PTAand I really believe that the
association is really steppingup to make it known that they
(20:18):
are inclusive of PTAs and theydo want the voice and that we
are one profession, and that'sreally all that really matters.
Speaker 1 (20:26):
Thanks for the overview of that and, again, I
think that's just part of ourprofession continuing to move
forward as well.
You spoke really well about whythat's important, so thank you,
ian, for that.
Hey, one other one that you guysbrought up and I guess some
thoughts that came into my mindhere is hey, every single one of
us, when we went through oureducation process as a PT or a
(20:50):
PTA, you know, really focused onmaybe some of the manual skills
that we're doing and we wouldhave those psychosocial aspects
of healthcare classes that wewould take but maybe not quite
see the value of those until weactually got out into the clinic
and realized that we're workingwith real people, right, and
real people have more thingsmixed up in what's going on
(21:11):
physically than just thephysical component, right, we
call that that biopsychosocialmodel, and so one of the motions
here was just the role of thephysical therapist in behavioral
and mental health, right,recognizing that, hey, we have a
lot of access to individualsthat maybe their mental health
(21:35):
or trauma or other things thathave happened in their lives are
also impacting some of theirphysical condition as well.
Can you guys talk about thatmotion and maybe why it's
valuable and what it does forour profession, moving forward.
Speaker 2 (21:50):
Yeah, I thought it was an important one for us.
The problem is, as far as thedebate went on the floor, it
wasn't like very encompassingbecause there's so much dialogue
that happened in the motionconcept leading into the rc and
then, even as we were developingthe rc, all the different
(22:11):
information from, like, thespecialists, so to speak, in
this field gave very movingreasons why we should have this
as a document for the APTA.
So I can't divulge like whatthose people say in the
background of the hub, but itwas very moving and, just like
(22:32):
you said, there's just a wholeother aspect of what we're
treating nowadays compared tojust the movement dysfunction
that these people bring to thetable.
There is a lot of mental healththat goes into your movement
dysfunction.
So it was really good and themotion passed with little to no
trouble.
So, yeah, I just thinkeverybody kind of understands.
(22:53):
Well, you just see in the worldall the trouble that we have
like.
Look at michigan with the, thethis guy stabbed the mental
health there, the, the shootingjust last night in in manhattan.
There's just a lot of mentalhealth things that we need to
keep in the forefront and sohaving a document like this
helps again, progress, theprofession and I think that it
(23:15):
was important.
Speaker 3 (23:16):
a lot of the talk was we spend so much time with our
patients and much more time thana physician or maybe even
nursing or any of some of thoseother professions.
I mean, there's not very manyprofessions that spend in the
healthcare field that spend 45minutes or an hour with somebody
that's not already on thepsychological side to begin with
(23:40):
, or a therapist, and sosometimes we're thrown into
those situations where you gettold some things and it's really
learning and understanding howto deal with it.
Speaker 1 (23:49):
Yeah, absolutely.
I remember a few years backbeing a CSM, and I went to a
panel discussion that had AdrianLowe on the panel and there was
a psychologist and and they'rereally you know, they're they're
kind of talking about this veryissue of hey, you guys are on
the front line, you're seeingthese individuals.
We know that it's difficult toget into counseling or into
psychologists at times, and soif we, if there's anything we
(24:11):
can do to help equip you or evenget that referral to psychology
, we need to make sure that PTsare equipped and knowledgeable
in those areas as well.
Speaker 2 (24:21):
So yeah, he kind of started this whole behavioral
health movement, is his groupand so I would use him and his
educators for state meetings,because I was the Western
district chair for the longesttime while I was just a delegate
, and so I would get meetingsgoing in the state before we had
(24:45):
zoom and before we had allthese cool things.
We would have to just meet faceto face and he would teach and
do a lot of the different hourlectures.
Uh, for the state of Nebraska.
Speaker 1 (24:56):
Oh, that's excellent.
Speaker 2 (24:59):
Yeah, because they were just down in Missouri.
Yeah, and so even when I workedin Lincoln at St Elizabeth's
before I got out to WesternNebraska, they would come up and
do talks in Lincoln and Omahaas well.
They're just a wealth ofknowledge.
They really help ourprogression or our profession
progress.
Speaker 1 (25:14):
Yep, and we all know kind of the chronic pain realm.
You know it's not just aphysiological issue that's
always going on.
There's a lot that's wrapped upin that Right.
Um, I was just having aconversation recently about
functional neurologic disordertoo, and there's a lot of just
kind of the mental health aspectthat's wrapped up in what's
(25:35):
manifesting in a physical wayand at least in the
neuromuscular realm.
Fnd it's up therediagnosis-wise, with actually
greater than MS and greater thanParkinson's disease and the
number of movement disordersthat are diagnosed in that way.
(25:55):
And so, yeah, this is a greatone.
I'm really glad that you guysbrought that up and it's
recognizing the role of thephysical therapist in that realm
too.
What else Offline?
We had a conversation aboutprimary care, physical therapy
and telehealth.
Do you guys want to go there?
Is there anything else that'skind of come up in your minds?
Speaker 2 (26:15):
Well, I think that kind of leads into why we
adopted a, uh, rc 17, um, 25.
It's because primary care ishere and it's going to stay in
physical therapy.
So the APTA is kind of helpinglead forward with how to make
that possible in educationprograms.
(26:36):
So yeah, rc 1725, superimportant Primary care is the
11th.
I think I said 12th earlier.
It's the 11th specialty withinthe APTA.
12th or later it's the 11thspecialty within the APTA.
So you will be able to applyfor specialization through the
American Physical TherapyAssociation.
To become a specialist inprimary care doesn't mean that
(26:59):
in our state practice acts wehave everything in a line to
practice that way yet.
So again, that might beconfusing to some people we
still have to abide by the lawsof our state in order to get
referrals to diagnostics, tomedication.
We do not have those powers yet, but there are some states that
(27:22):
have radiology, that have alittle bit of laboratory
referrals that they can do.
So we as a state of Nebraskajust need to open up our
practice act which is not easyto do and start to go through
the legal process of gainingcertain rights, certain laws
(27:43):
that will allow us to refer foran MRI and refer for some
medication that makes sense inour movement spectrum, refer for
lab tests to look to see howour diabetic patients are doing
with exercising and bloodglucose control.
Those sorts of things are kindof cool to think about and
(28:05):
that's why the APTA adopted thisprimary care specialization so
we can start to get theeducation of primary care into
physical therapists and then,once that happens, we'll show
that we have value in the systemto function, just as the
physical therapists in the armedforces have been since the 70s.
Speaker 1 (28:27):
If you're not familiar, sorry, go ahead, Ian.
Speaker 3 (28:29):
I was going to say, and hopefully someday.
I mean I think Utah just passedtheir primary care there here,
or just they passed theirlegislation to allow the PTs or
recognize as primary careproviders.
So hopefully someday.
Speaker 1 (28:44):
Yeah, I'm not going to make you guys talk about it
right now but, for the listeners, if you're not familiar with
primary care physical therapy,I'll put a couple resources into
the show notes.
There's a really good podcastwith Utah's state chapter
president just talking about theprocess that they went through
(29:05):
to get recognized as primarycare providers within their
state, and then there's somegood resources that have come
out from the Federal Academy ofthe APTA, just kind of talking
through.
What does primary careintegration look like in more of
the I don't know what the wordis for civilian healthcare
(29:27):
environment as opposed to themilitary healthcare environment?
Right, Like you talked about,you know there's been socialized
medicine within the militaryfor a very long time, and so the
way that PTs can operate withinthat setting is different than
what we're dealing with in moreof a civilian environment.
So, yeah, great, that's anotherreally good one, I think, for
(29:49):
us to be aware of and the impacton our profession moving
forward.
We have time for probably onemore guys.
Where would you like to go?
Speaker 3 (30:02):
Ian, did you have one that was a particular on the
education side of things?
I mean it's more geared towardsPT practice or DPT programs.
But just you know, thearguments is to we're always
looking to that ways to savemoney.
I mean you can look atcompany-based education and see
ways that you might be able tosave money If there are some
things that can be checked offor there's some things that we
(30:25):
can do to help eliminate some ofthose costs, especially as
things are changing when we'relooking at grad school and those
types of things.
But the talk at the house kindof the pushback on the RC and I
don't remember the RC number offthe top of my head, but the
(30:45):
pushback on that there was areport by the APTA that came out
the day after the House thatdoes discuss some of the
components of company-basededucation.
So I'd encourage members to gocheck that out to learn a little
bit more about it.
But I think that that'll besomething that will.
Obviously we have a school herein the state that is really big
(31:06):
on competency-based educationand the development of it at
Creighton, and so I think it'llbe an argument that will come.
I don't want to say an argument, but it'll be something that
will be discussed in the futureand it'll continue to maybe look
at ways to incorporate thatdown the road.
Speaker 1 (31:22):
Yeah, competency-based education isn't
necessarily new, but it's maybea little newer to physical
therapy education.
Again, I think Gail Jensen hasbeen a big part of that and a
few of the other instructors atCreighton University have been
helpful in spearheading some ofthat.
I think, even from what I'mgathering from you guys, a lot
(31:43):
of people are still trying tokind of wrap their head around
what does that look like as aneducational model?
What does that change?
I don't have all the answersfor some of that, but maybe an
observation.
You know, as someone who's newerin academia but spent a long
time as a clinical instructor, Ithink my perspective as a
(32:08):
clinical instructor Ian,hopefully you appreciate this as
a DCE too my perspective as aclinical instructor was hey, you
have a good, solid foundationcoming into the clinic and I've
really got to kind of sharpenthat up and tighten that up in a
lot of ways within your timewith me and coming into academia
.
There's a temptation for me towant to teach everything I know
(32:31):
as a clinician to my students.
Right, and there's always abalance of what's need to know
and what's nice to know,especially early on, and helping
to create entry-levelclinicians, and I've really just
learned to respect how much weneed our clinical instructors to
be a solid part of thateducation process and we have to
(32:54):
lean on them in a lot of waysto add in more information and
to layer on top of what we'vebeen able to do within the
classroom and lab settingsalready.
And so there's really thisseamless process that has to
happen from classroom intoclinic before becoming a
full-fledged PT, licensed PT orPTA, so to say right.
Speaker 3 (33:17):
Yep.
Speaker 1 (33:18):
And competency-based education.
As we continue to learn moreabout that and engage with it, I
think that we will need thehelp of our CIs and there will
be a lot of engagement of thatclinical community to try to
understand what that looks like.
Speaker 2 (33:36):
Hopefully I'm not speaking out of turn on that,
but Absolutely not.
Yeah, I'll also put in a plugfor any member that's listening
to this.
We're going to need sites forprimary care to have different
residencies.
So something to think aboutgoing forward have your clinic
be a residency for eitherCreighton or UNMC.
Speaker 1 (33:55):
Yeah, and again, if you're not quite sure what that
means, I'm going to try to giveyou some resources in the show
notes to kind of bring that bardown just a little bit and help
us understand, wrap our mindsaround what that is.
Well, hey guys, thanks for theconversation, thanks for
representing the state and justfor everything that you do as
(34:19):
delegates for us at House ofDelegates.
Any parting words, final wisdomthat you want to belie upon us,
appreciate the time.
Speaker 3 (34:30):
Yeah, absolutely, I think, if anybody's interested.
I mean, there's positions thatare typically open every year.
That evidence may seem boring,but it really is not.
There's a lot that goes onthere and a lot to learn, and I
do come back energized everytime I go to the house and I'm
hoping that I'll have other PTAsin the future that would like
(34:50):
the role that I have, or we'llrun for a delegate position,
since now in the state ofNebraska you can do that.
Speaker 1 (34:56):
Excellent.
Well, guys, thanks again for ohgo ahead.
Speaker 2 (34:59):
The intimidation down of of having to run for
governance.
I'll make it really easy on you.
Speaker 1 (35:06):
Good, you have Bobby's support already.
Anyone that wants to fly?
Speaker 2 (35:09):
Just run.
Speaker 1 (35:10):
I love it.
I love it, guys.
Thanks again for your time.
Appreciate the conversation andaudience.
I hope that this was helpfulfor you too.
Thanks for tuning in to theAPTA Nebraska podcast.
Stay connected with us for moreconversations that elevate our
profession and improve the livesof Nebraskans.
Don't forget to subscribe,share and join the discussion
(35:32):
because together we're drivingthe future of physical therapy
forward.
Welcome to the APTA Nebraska podcast, where we dive
into the stories, challenges andinnovations shaping physical
therapy in our state.
We're here to advance, promoteand protect the practice of
physical therapy, optimizing thehealth and quality of life for
all Nebraskans.
Join us as we connect withexperts, share insights and
(00:22):
build communities throughout ourprofession.
Connect with experts, shareinsights and build communities
throughout our profession.
Welcome back to the APTANebraska podcast.
I'm Brad Dexter, your host, andI'm joined by Bobby Greasy and
Ian Thompson today, who aregoing to share a little bit
about their time at the House ofDelegates in July.
Guys, welcome to the podcast.
Speaker 2 (00:39):
Thank you very much.
Thanks for having us.
Speaker 1 (00:41):
So just a little bit of background.
If you're not as familiar withhow the House of Delegates works
and guys, feel free to jump inand correct me on anything that
I miss.
Here there's a House ofDelegates that is responsible
within the APTA for continuingto kind of move our profession
forward.
(01:01):
Is that a fair way ofexplaining that?
Yep, continuing to kind of moveour profession forward Is that
a fair way of explaining that?
You guys, on behalf of ourstate, you were there as a
delegation.
You're voting on motions thatare on the floor.
Part of that process is justrecognizing that physical
therapy as a professioncontinues to evolve and change
and we need to make sure thatyou know what we.
(01:22):
You might have to help me withthe language behind this, but
what we're writing about ourprofession is kind of catching
up to that as well.
Is that fair to say?
Speaker 2 (01:31):
In a nutshell In a nutshell.
Speaker 1 (01:33):
I'm sure you could describe that much better than
me, but you were telling mebefore, bobby, that, okay, there
are 438 voting delegates at theHouse of Delegates.
That does not representeveryone that's there,
necessarily.
I think there's a naturalquestion then of well, how do
you know how many delegates youget for each state?
That's representative of theamount of members that you have
(01:56):
in your state chapter, right?
Speaker 2 (01:57):
So state membership and we have five voting
delegates and we're super close,so if we got anybody on here
that wants to become a member,then we could ultimately get up
to six voting delegates okay, soour voice, then, as a state
within the APTA, as a nationalorganization is, is just a
little bit louder than with, youknow, another vote right, like,
(02:20):
like, north Dakota only has twovoting delegates OK, because
their membership of course isnot very large.
Up there, alaska too, I mean,there's these small states and
they all have two.
So we are actually pretty luckyin Nebraska to have five,
because we're still a smallstate, but we have five voting
delegates because our membershipis so strong.
Speaker 1 (02:42):
It's so high.
That's great, yeah, okay, so,as membership chair, there's
everything you need to know.
We need more members and it'svaluable because it gives us a
voice at that national level too.
Thanks for saying that.
I appreciate that.
So you guys I was lookingthrough, kind of, the agenda for
(03:04):
House of Delegates.
There were 48 different motionsthat you guys had to look
through.
Can you maybe just share withthe audience?
When do you get those motions?
How many pages are there?
What's your responsibility toread through those motions
before you actually end up onthe floor and voting on these
things?
Speaker 2 (03:23):
Yeah, so we are changing with the times and
developing our motionsdifferently now than we have in
the past, and so our first phasefrom February through April,
was motion concepts, and so wehave this hub online through the
APTA and all of us chiefdelegates and delegates have the
(03:45):
motion concepts in front of usand there's discussions through
emails that go around for thefirst three months of developing
a motion, and we didn't bring amotion to the House that wasn't
in concept form to start with.
So I don't know if that'sconfusing.
So we're going from concept tomotion.
(04:05):
If the concept is not accepted,then it doesn't become a motion
and then, once it becomes amotion, then we start to work on
dialogue about that motion andthen we don't debate, and that's
confusing, I know, but we don'tdebate a motion until the House
comes about in July.
Speaker 1 (04:25):
Okay, so I mean in other words like, yeah, you
can't, you don't want to have100 motions that everyone's
responsible for, and so there'sa process that you go through to
even get that concept or ideato become a motion, something
that's valuable enough thatHouse of Delegates needs to
actually vote on that enoughthat House of Delegates needs to
(04:48):
actually vote on that.
Speaker 2 (04:48):
In the past couple years we've had a couple of
motions that haven't been seenas something that's beneficial
to the association, and so theboard and the directors and
everybody is trying to develop aprocess that's more transparent
so that everybody has a say all438 voting delegates have a say
before it becomes a motion, tomake sure that it's something of
(05:09):
value to the association.
Speaker 1 (05:11):
Okay, so that kind of happens between February and
April and then it moves intomotion.
You guys get those motions,review them, and then you have a
chance to vote on them at Houseof Delegates, right?
Speaker 2 (05:24):
So, just to give you an example, we had over 3,000
emails in our motion conceptdevelopment.
That's very busy.
That's a lot of people givinginput and getting input, because
it's not just somebody tellingyou what they think, it's also
there's questions and thenanswers from the APTA staff and
(05:47):
answers from the board ofdirectors to kind of help guide
our thought processes.
Speaker 1 (05:52):
Okay.
Speaker 2 (05:53):
It's busy.
I looked at my emails every day.
Speaker 1 (05:56):
Wow, that's maybe a good place for me to pause and
remind people that you guys alsohave full-time day jobs, right?
Speaker 2 (06:03):
Yep, bobby, you're in Shadron, yeah, I can tell you a
little bit about that.
I'm out in Shadron, nebraska,of course, a small rural
community hospital.
I've been practicing 23 years.
I've been a delegate since 2004, and I've been a chief delegate
since 2017.
I have a lot of experience inthe governance process and I
(06:24):
just have a lot of experience onhow we of experience in the
governance process and I justhave a lot of experience on how
we've evolved in the governanceprocess, because before there
was no computers, you didn'tbring your laptop.
There's no cell phones.
We just had three ring bindersof hundreds of papers.
Speaker 1 (06:38):
Wow, yeah, that means a heavy backpack.
Speaker 2 (06:41):
It was, everybody had a heavy backpack.
That means a heavy backpack.
Speaker 1 (06:43):
It was.
Everybody had a heavy backpack.
And, Ian, can you tell ouraudience where you're located
and what you do too?
Speaker 3 (06:50):
Absolutely.
I am an instructor in the DCEat Southeast Community College
in the PTA program.
I've been the well.
Originally I was a caucus repand I can talk a little bit
later about how that's evolved.
Rep and I can talk a little bitlater about how that's evolved.
But I was the caucus rep I waselected in.
I believe 2020 was my firsthouse.
(07:12):
I want to say I was elected in19,.
Actually, 2020 was the firsthouse which was a COVID house
and I've been going to themsince.
We've since changed to theengagement group and so it's our
role in governance is just alittle bit different than it was
prior, because now we have twovoting delegates that are part
(07:33):
of the PTA council and so wehelp to steer their decisions
when they go to the house floorand vote.
Speaker 1 (07:39):
Okay, thanks, yeah, thanks.
Thanks for giving us just alittle bit better idea of the
fact that, oh yeah, you guys areworking all long and then
you're maybe having to siftthrough 3000 emails over the
course of a motions.
That was on the floor and I'llbet our podcast listens would be
(08:07):
at maybe like one.
It would be my mom who wouldprobably last through that
entire thing.
But I do want to hear from youguys you know what kind of stood
out during your time at Houseof Delegates what do you think
would be of value for ourmembership in our state chapter
in Nebraska to be aware of?
Speaker 2 (08:30):
Yeah, thank you for that question.
So just a little background.
The governance process for theAmerican Physical Therapy
Association is our House ofDelegates and we are elected by
the state.
But then there's also sectionsthat will elect two members and,
like Ian said, the physicaltherapy council now physical
therapy assistant council hastwo members that are voting, so
(08:53):
438 votes on the floor.
We try to encompass everyaspect of physical therapy, so
it's education, it's clinicalbased, and then this year was a
bylaw year.
So then it's also something asimportant as code of ethics,
(09:15):
mission vision.
All those sort of things arebrought forth and voted on by
the House of Delegates.
Again, this year was bylaw year.
On the zero years and fiveyears we bring forth bylaws.
Code of Ethics was our mostimportant bylaw this year.
It's been a four-year processby a task force Gail, I was
(09:37):
saying earlier, gail Jensen saton this task force from
Creighton University.
She's just a wealth ofknowledge in the ethics area and
what was brought forward is webrought together PTA code of
ethics and PT code of ethics andmade one solid document.
Some of the verbiage wasdebated a little bit on the
(09:59):
floor and felt that it wasn'tpowerful enough, but when it all
came down to it.
We adopted the code of ethicswith almost a unanimous vote and
got a very good document goingforward.
For any litigation, for anyproblems that you see in your
(10:20):
day-to-day actions withcoworkers, please use that code
of ethics as a resource formoving forward, cause I think
it'll stand up for at least thenext 10 years as far as how
we're going to practice physicaltherapy.
Speaker 1 (10:38):
Can you guys maybe either one of you would you be
able to talk about like why?
Why is it important that the PTcode of ethics and the PTA code
of ethics kind of mergedtogether?
Speaker 2 (10:49):
Yeah, I mean Ian can can jump on this too.
But as far as having twodifferent documents, they didn't
.
They didn't coincide withtoday's practice standards, and
so what they did, instead ofhaving you go to two different
documents, is they just moldedit into one universal document
(11:10):
for both PTs and PTAs.
Just to you know, help thepublic, help lawyers understand
how physical therapists shouldpractice so that when they're
looking at these differentethical dilemmas, then you don't
have so many documents.
Speaker 3 (11:26):
And I think the one thing too is when we're looking
under physical therapistpractice in general, that's
where the physical therapistassistant falls is under
physical therapist practice, andso having as looking at us as a
team versus separate, thenwe're we're all, all should be,
we all should be ethical right,we all should be doing what's
(11:48):
best for our patients, what'sbest for the profession, those
types of things.
And so having one document thatserves physical therapist
practice the best, with thephysical therapist assistant
falling under that just was itjust made sense?
Speaker 1 (12:01):
Excellent.
Thank you, and Bobby, I think Icut you off a little bit.
Did you have anything else thatyou wanted to add on the bylaws
?
Speaker 2 (12:07):
Well, as far as the bylaws go, I think it's
important for members in thestate of Nebraska to know that
litigation can come aboutbecause of documents from the
APTA, and so it's reallyimportant that we keep up to
speed with what's happening inthe country, because we have had
(12:29):
trouble with physicaltherapists across the country.
There's no specifics and wecan't name anybody, but we've
had litigation against physicaltherapists because of different
core documents through thePhysical Therapy Association.
So the board and the APTA staffwas really big this year in how
(12:50):
we worded our documentationthat we passed in order to
protect every physical therapist, not just the members.
Now, the members, of course,are, so to speak, the most
important, but it also protectsjust everyday practicing
therapists too, because theassociation only represents 30%
(13:11):
of practicing physicaltherapists across the nation.
So it's important to also givethose non-members some
assistance as well, and so theAPTA Code of Ethics is one of
those documents that can moveacross the association and to
the non-members.
But as far as passing thedocuments, we're most concerned
(13:34):
with our membership.
Okay, so I did.
You know, as far as bylaws go,it's different every five years
on what our practice standardsare and how they're changing.
So, for instance the code ofethics was adopted.
So that means that it was thisfresh document that had never
been seen before by the housebecause there was two code of
(13:56):
ethics for PTs and PTAs.
So then we molded together.
So the adoption of that RC wasdifferent than the other seven,
because then the other sevenwere just amendments to already
standing bylaws and they didn'tall pass either.
So that's kind of interestingthat the House of Delegates
didn't feel like the changesthat needed to be made.
(14:18):
From the mainly the boardbrings forward the bylaw
amendments, mainly the boardbrings forward the bylaw
amendments.
They didn't feel like thoseamendments were of enough
substance and so some of thebylaws failed, which is kind of
ironic because then we'll haveto wait another five years.
We can see bylaws every year butyou have to vote them in to a
(14:39):
non-bylaw year by a two-thirdsvote and sometimes that can be
pretty tough to get in.
But I want to highlight onemore bylaw.
As far as an amendment goes andI want Ian to talk a little bit
about this we voted in anamendment that gives the
physical therapy assistant achance to run for a director
(15:00):
position, and a director is oneof nine people on the board, the
executive board that governsthe House of Delegates.
So you have APTA staff, youhave the board of directors and
then you have the House ofDelegates, is the governance for
(15:20):
the American Physical TherapyAssociation, and so that might
be a little confusing to people.
And again, I'm always up foranswering any questions if I get
emails or phone calls orwhatever questions you have
about the governance of theAmerican Physical Therapy
Association, because I don'tever get too many people that
are interested in it.
(15:41):
So I would entertain any andall questions if it's confusing,
because I'm sure it is to somepeople.
Speaker 1 (15:48):
Now, Ian, why don't you maybe fill us in a little
bit more?
Speaker 3 (15:51):
All right, I will talk about RC525, which was a
bylaw change that would grantthe PTA an opportunity to serve
on the board of directors, andoriginally we had hoped that we
would have a physical therapistassistant that would have a
designated spot on the board ofdirectors.
This was an RC that was broughtforth by the state of Oregon
(16:11):
and the PTA council.
Just a little bit of backgroundIn 2015, there were three
bylaws that were brought forthand, just like Bobby said, bylaw
years are the fives and thezeros, and so there were three
bylaws in 2015 that were broughtforward.
One was to give the full voteto the PTA at the component
level.
The other one was to allow aPTA to serve as a chapter
(16:35):
delegate and the third one wasthe opportunity to serve on the
board.
Well, that's taken a little bitof time, but in 2015, we got
the first one with the vote atthe component level, and
Nebraska was one of those firsteight states that voted that
through right away, so we werepretty happy about that.
Two years ago, we now voted inan RC that bylaw change that
(16:58):
would allow the PTA to serve asa chapter delegate.
So we were at two out of threeof those original bylaws from
2015.
And so the board of directorsone was pretty important to us
the AOTA, or our friends, ouroccupational therapy friends.
They do have a bylaw thatdesignates one particular
position or one position ontheir board of directors to a
(17:19):
CODA, but it doesn't limit thenumber that that can run.
And so currently there's twoCODAs on the board of directors
for the AOTA, and so that'ssomething that we were really
hoping for, and there was somedebate.
There was an amendment that wasintroduced pretty much right
away that asked that, instead ofa designated position, that a
(17:41):
PTA could run as an at-largeperson for those positions.
And you know, initially I thinkwe were really hoping for that
one position, because it may bedifficult for a PTA to to win
one of those positions against aPT, but there are some really,
(18:02):
really good candidates out thereright now.
So that was something then thatwe really thought a win is a
win, so whatever could get usacross the finish line, at least
allow us to potentially havethat voice.
We have a lot of PTAs out therethat are in leadership already.
There's's some, as myself, thatserve on the exec board at the
state level.
There's PTAs that are clinicowners and so allowing them to
(18:24):
have some of the same voicesthat our PT friends have as well
.
We thought was pretty important.
So we were pretty happy aboutthe bylaw and we were okay with
that amendment because now,instead of the one designated
position I mean technically,there was some talk about
whether a PTA could, essentiallyyou could have eight on the
(18:44):
board, which will never happenbecause there's a nominating
committee that's going to be incharge of helping to build that
slate to begin with, but it didallow the opportunity for us to
maybe have more people.
So, like I said, the AOTA hasone designated position but
right now has two COTAs that siton their board, and so we do
(19:04):
have the opportunity to run as aboard of directors for board of
directors position, and so,whether it's one or whether it's
two I know it will never beeight, but just the fact that we
can have one I think was areally big win for the PTAs and
there were I want to say at theend there were 17 co-sponsors to
(19:27):
that and it passed prettyeasily.
So we were happy about that andjust the wins that we've seen
for the PTAs.
I think there was adisassociation for a while with
the association itself with thePTAs, because we used to have a
vote and they took the vote wastaken away.
But now we've gotten back tothat full vote.
Now we have two voting members,now we can run as a delegate
(19:52):
position and so all of thosethings and even the delegate
spots.
That was a bylaw change thathappened in a non-bylaw year.
So, as Bobby said, we neededtwo-thirds vote just to hear it
and then we needed thetwo-thirds to pass it and we
were able to achieve that.
So just some wins for the PTAand I really believe that the
association is really steppingup to make it known that they
(20:18):
are inclusive of PTAs and theydo want the voice and that we
are one profession, and that'sreally all that really matters.
Speaker 1 (20:26):
Thanks for the overview of that and, again, I
think that's just part of ourprofession continuing to move
forward as well.
You spoke really well about whythat's important, so thank you,
ian, for that.
Hey, one other one that you guysbrought up and I guess some
thoughts that came into my mindhere is hey, every single one of
us, when we went through oureducation process as a PT or a
(20:50):
PTA, you know, really focused onmaybe some of the manual skills
that we're doing and we wouldhave those psychosocial aspects
of healthcare classes that wewould take but maybe not quite
see the value of those until weactually got out into the clinic
and realized that we're workingwith real people, right, and
real people have more thingsmixed up in what's going on
(21:11):
physically than just thephysical component, right, we
call that that biopsychosocialmodel, and so one of the motions
here was just the role of thephysical therapist in behavioral
and mental health, right,recognizing that, hey, we have a
lot of access to individualsthat maybe their mental health
(21:35):
or trauma or other things thathave happened in their lives are
also impacting some of theirphysical condition as well.
Can you guys talk about thatmotion and maybe why it's
valuable and what it does forour profession, moving forward.
Speaker 2 (21:50):
Yeah, I thought it was an important one for us.
The problem is, as far as thedebate went on the floor, it
wasn't like very encompassingbecause there's so much dialogue
that happened in the motionconcept leading into the rc and
then, even as we were developingthe rc, all the different
(22:11):
information from, like, thespecialists, so to speak, in
this field gave very movingreasons why we should have this
as a document for the APTA.
So I can't divulge like whatthose people say in the
background of the hub, but itwas very moving and, just like
(22:32):
you said, there's just a wholeother aspect of what we're
treating nowadays compared tojust the movement dysfunction
that these people bring to thetable.
There is a lot of mental healththat goes into your movement
dysfunction.
So it was really good and themotion passed with little to no
trouble.
So, yeah, I just thinkeverybody kind of understands.
(22:53):
Well, you just see in the worldall the trouble that we have
like.
Look at michigan with the, thethis guy stabbed the mental
health there, the, the shootingjust last night in in manhattan.
There's just a lot of mentalhealth things that we need to
keep in the forefront and sohaving a document like this
helps again, progress, theprofession and I think that it
(23:15):
was important.
Speaker 3 (23:16):
a lot of the talk was we spend so much time with our
patients and much more time thana physician or maybe even
nursing or any of some of thoseother professions.
I mean, there's not very manyprofessions that spend in the
healthcare field that spend 45minutes or an hour with somebody
that's not already on thepsychological side to begin with
(23:40):
, or a therapist, and sosometimes we're thrown into
those situations where you gettold some things and it's really
learning and understanding howto deal with it.
Speaker 1 (23:49):
Yeah, absolutely.
I remember a few years backbeing a CSM, and I went to a
panel discussion that had AdrianLowe on the panel and there was
a psychologist and and they'rereally you know, they're they're
kind of talking about this veryissue of hey, you guys are on
the front line, you're seeingthese individuals.
We know that it's difficult toget into counseling or into
psychologists at times, and soif we, if there's anything we
(24:11):
can do to help equip you or evenget that referral to psychology
, we need to make sure that PTsare equipped and knowledgeable
in those areas as well.
Speaker 2 (24:21):
So yeah, he kind of started this whole behavioral
health movement, is his groupand so I would use him and his
educators for state meetings,because I was the Western
district chair for the longesttime while I was just a delegate
, and so I would get meetingsgoing in the state before we had
(24:45):
zoom and before we had allthese cool things.
We would have to just meet faceto face and he would teach and
do a lot of the different hourlectures.
Uh, for the state of Nebraska.
Speaker 1 (24:56):
Oh, that's excellent.
Speaker 2 (24:59):
Yeah, because they were just down in Missouri.
Yeah, and so even when I workedin Lincoln at St Elizabeth's
before I got out to WesternNebraska, they would come up and
do talks in Lincoln and Omahaas well.
They're just a wealth ofknowledge.
They really help ourprogression or our profession
progress.
Speaker 1 (25:14):
Yep, and we all know kind of the chronic pain realm.
You know it's not just aphysiological issue that's
always going on.
There's a lot that's wrapped upin that Right.
Um, I was just having aconversation recently about
functional neurologic disordertoo, and there's a lot of just
kind of the mental health aspectthat's wrapped up in what's
(25:35):
manifesting in a physical wayand at least in the
neuromuscular realm.
Fnd it's up therediagnosis-wise, with actually
greater than MS and greater thanParkinson's disease and the
number of movement disordersthat are diagnosed in that way.
(25:55):
And so, yeah, this is a greatone.
I'm really glad that you guysbrought that up and it's
recognizing the role of thephysical therapist in that realm
too.
What else Offline?
We had a conversation aboutprimary care, physical therapy
and telehealth.
Do you guys want to go there?
Is there anything else that'skind of come up in your minds?
Speaker 2 (26:15):
Well, I think that kind of leads into why we
adopted a, uh, rc 17, um, 25.
It's because primary care ishere and it's going to stay in
physical therapy.
So the APTA is kind of helpinglead forward with how to make
that possible in educationprograms.
(26:36):
So yeah, rc 1725, superimportant Primary care is the
11th.
I think I said 12th earlier.
It's the 11th specialty withinthe APTA.
12th or later it's the 11thspecialty within the APTA.
So you will be able to applyfor specialization through the
American Physical TherapyAssociation.
To become a specialist inprimary care doesn't mean that
(26:59):
in our state practice acts wehave everything in a line to
practice that way yet.
So again, that might beconfusing to some people we
still have to abide by the lawsof our state in order to get
referrals to diagnostics, tomedication.
We do not have those powers yet, but there are some states that
(27:22):
have radiology, that have alittle bit of laboratory
referrals that they can do.
So we as a state of Nebraskajust need to open up our
practice act which is not easyto do and start to go through
the legal process of gainingcertain rights, certain laws
(27:43):
that will allow us to refer foran MRI and refer for some
medication that makes sense inour movement spectrum, refer for
lab tests to look to see howour diabetic patients are doing
with exercising and bloodglucose control.
Those sorts of things are kindof cool to think about and
(28:05):
that's why the APTA adopted thisprimary care specialization so
we can start to get theeducation of primary care into
physical therapists and then,once that happens, we'll show
that we have value in the systemto function, just as the
physical therapists in the armedforces have been since the 70s.
Speaker 1 (28:27):
If you're not familiar, sorry, go ahead, Ian.
Speaker 3 (28:29):
I was going to say, and hopefully someday.
I mean I think Utah just passedtheir primary care there here,
or just they passed theirlegislation to allow the PTs or
recognize as primary careproviders.
So hopefully someday.
Speaker 1 (28:44):
Yeah, I'm not going to make you guys talk about it
right now but, for the listeners, if you're not familiar with
primary care physical therapy,I'll put a couple resources into
the show notes.
There's a really good podcastwith Utah's state chapter
president just talking about theprocess that they went through
(29:05):
to get recognized as primarycare providers within their
state, and then there's somegood resources that have come
out from the Federal Academy ofthe APTA, just kind of talking
through.
What does primary careintegration look like in more of
the I don't know what the wordis for civilian healthcare
(29:27):
environment as opposed to themilitary healthcare environment?
Right, Like you talked about,you know there's been socialized
medicine within the militaryfor a very long time, and so the
way that PTs can operate withinthat setting is different than
what we're dealing with in moreof a civilian environment.
So, yeah, great, that's anotherreally good one, I think, for
(29:49):
us to be aware of and the impacton our profession moving
forward.
We have time for probably onemore guys.
Where would you like to go?
Speaker 3 (30:02):
Ian, did you have one that was a particular on the
education side of things?
I mean it's more geared towardsPT practice or DPT programs.
But just you know, thearguments is to we're always
looking to that ways to savemoney.
I mean you can look atcompany-based education and see
ways that you might be able tosave money If there are some
things that can be checked offor there's some things that we
(30:25):
can do to help eliminate some ofthose costs, especially as
things are changing when we'relooking at grad school and those
types of things.
But the talk at the house kindof the pushback on the RC and I
don't remember the RC number offthe top of my head, but the
(30:45):
pushback on that there was areport by the APTA that came out
the day after the House thatdoes discuss some of the
components of company-basededucation.
So I'd encourage members to gocheck that out to learn a little
bit more about it.
But I think that that'll besomething that will.
Obviously we have a school herein the state that is really big
(31:06):
on competency-based educationand the development of it at
Creighton, and so I think it'llbe an argument that will come.
I don't want to say an argument, but it'll be something that
will be discussed in the futureand it'll continue to maybe look
at ways to incorporate thatdown the road.
Speaker 1 (31:22):
Yeah, competency-based education isn't
necessarily new, but it's maybea little newer to physical
therapy education.
Again, I think Gail Jensen hasbeen a big part of that and a
few of the other instructors atCreighton University have been
helpful in spearheading some ofthat.
I think, even from what I'mgathering from you guys, a lot
(31:43):
of people are still trying tokind of wrap their head around
what does that look like as aneducational model?
What does that change?
I don't have all the answersfor some of that, but maybe an
observation.
You know, as someone who's newerin academia but spent a long
time as a clinical instructor, Ithink my perspective as a
(32:08):
clinical instructor Ian,hopefully you appreciate this as
a DCE too my perspective as aclinical instructor was hey, you
have a good, solid foundationcoming into the clinic and I've
really got to kind of sharpenthat up and tighten that up in a
lot of ways within your timewith me and coming into academia
.
There's a temptation for me towant to teach everything I know
(32:31):
as a clinician to my students.
Right, and there's always abalance of what's need to know
and what's nice to know,especially early on, and helping
to create entry-levelclinicians, and I've really just
learned to respect how much weneed our clinical instructors to
be a solid part of thateducation process and we have to
(32:54):
lean on them in a lot of waysto add in more information and
to layer on top of what we'vebeen able to do within the
classroom and lab settingsalready.
And so there's really thisseamless process that has to
happen from classroom intoclinic before becoming a
full-fledged PT, licensed PT orPTA, so to say right.
Speaker 3 (33:17):
Yep.
Speaker 1 (33:18):
And competency-based education.
As we continue to learn moreabout that and engage with it, I
think that we will need thehelp of our CIs and there will
be a lot of engagement of thatclinical community to try to
understand what that looks like.
Speaker 2 (33:36):
Hopefully I'm not speaking out of turn on that,
but Absolutely not.
Yeah, I'll also put in a plugfor any member that's listening
to this.
We're going to need sites forprimary care to have different
residencies.
So something to think aboutgoing forward have your clinic
be a residency for eitherCreighton or UNMC.
Speaker 1 (33:55):
Yeah, and again, if you're not quite sure what that
means, I'm going to try to giveyou some resources in the show
notes to kind of bring that bardown just a little bit and help
us understand, wrap our mindsaround what that is.
Well, hey guys, thanks for theconversation, thanks for
representing the state and justfor everything that you do as
(34:19):
delegates for us at House ofDelegates.
Any parting words, final wisdomthat you want to belie upon us,
appreciate the time.
Speaker 3 (34:30):
Yeah, absolutely, I think, if anybody's interested.
I mean, there's positions thatare typically open every year.
That evidence may seem boring,but it really is not.
There's a lot that goes onthere and a lot to learn, and I
do come back energized everytime I go to the house and I'm
hoping that I'll have other PTAsin the future that would like
(34:50):
the role that I have, or we'llrun for a delegate position,
since now in the state ofNebraska you can do that.
Speaker 1 (34:56):
Excellent.
Well, guys, thanks again for ohgo ahead.
Speaker 2 (34:59):
The intimidation down of of having to run for
governance.
I'll make it really easy on you.
Speaker 1 (35:06):
Good, you have Bobby's support already.
Anyone that wants to fly?
Speaker 2 (35:09):
Just run.
Speaker 1 (35:10):
I love it.
I love it, guys.
Thanks again for your time.
Appreciate the conversation andaudience.
I hope that this was helpfulfor you too.
Thanks for tuning in to theAPTA Nebraska podcast.
Stay connected with us for moreconversations that elevate our
profession and improve the livesof Nebraskans.
Don't forget to subscribe,share and join the discussion
(35:32):
because together we're drivingthe future of physical therapy
forward.
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